The Importance of Renal Function in Evaluating Response to Resynchronisation Therapy in Patients with Heart Failure after Implantation of Cardiac Resynchronisation Therapy and Defibrillator
Author(s): Agnieszka Debska-Kozlowska, Marcin Ksiazczyk, Andrzej Lubinski
Cardiac resynchronisation therapy (CRT) has a well-established position as one of the forms of treatment of selected groups of patients with heart failure (HF). Unfortunately, according to different data from the literature, the percentage of patients not responding to treatment using CRT remains consistently high and is estimated at around 20% to nearly 50%, according to the accepted definition of response to resynchronisation therapy. The aim of our work is to assess the impact of renal function in evaluating the response to resynchronisation therapy in a 12-month observation. The study included 46 patients with heart failure meeting the criteria and qualified for implantation of cardiac resynchronisation therapy and defibrillator (CRT-D), hospitalized in the Department of Interventional Cardiology and Cardiac Arrhythmias of the Medical University of Lodz. A responder to CRT was defined as a person who lived a certain time of observation with no episodes of HF exacerbation and improved his/her physical fitness referring to a decline in functional class by at least 1 degree according to the NYHA. In our study we determined empirical cut-off points for initial concentrations of creatinine and GFR-MDRD which can predict positive therapeutic response to CRT. The effect of resynchronisation therapy on improving kidney function remains debatable and requires further research.